Physician: Helping Adoptive Families Prepare

Adequate preparation can prevent child abuse.

Sonia Billadeau February 15, 2014
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What can the adoption community do as a whole in order to better prepare its families for international adoption?

Child abuse unfortunately occurs too frequently in all cultures, societies, and social classes. When an alcoholic, drug-using father from some small town somewhere abuses a child, other than a headline in the local newspaper, no one really knows about it.  On the other hand, when an adoptive parent abuses a child, the case attracts worldwide attention.Why then all of the attention to adoptive parents? This occurs because the media feels that it makes for interesting reporting.

Which headline sounds better and will bring will bring more television viewers?

  • “Small town alcoholic parent beats his child and places him in the hospital,” or
  • “Well-to-do adoptive parents beat their internationally adopted child and place him in the hospital.”

The media is what it is; it is a free country and anyone can write what they feel. There is nothing that can be done to lower the radar on adoptive parents in terms of child abuse. However, professionals can help to prevent child abuse by better preparing their adoptive parents for the challenges that they may encounter, as well as help them deal with life’s stresses created by their international adoption before the parents reach the point where they may hurt the child.

In order to weed out the potentially bad parents that may be capable of abusing or neglecting a child, the adoption profession needs to have stringent system of checks and balances to find a potential case before harm occurs to a child. A number of professions need to work together with the adoption agencies to investigate the adoptive parents’ background, but more importantly, to follow-up on the child for many months– to many years– after the adoption is complete.

Prior to the adoption, social workers need to interview and weed out the few bad apples. During a home study, the social worker will look into the personal lives of the adoptive parents, look into their child-rearing beliefs, and determine their psychological readiness. The international adoption process can take a very long time from start to completion. Agencies can use this time to help educate and support their clients. Parents can also use this time to help themselves by reading everything they can about issues pertaining to their adoptive child. Agencies can be more efficient in their educational roles by mandating parents to take child-rearing classes and other classes pertaining to the medical and behavioral problems which may be encountered in the internationally adopted child.

A well-informed parent will be better able to handle a problem when it occurs as opposed to a family who feels that all they need to do in order for a successful adoption is to bring the child home, put him into GAP clothing, and give the child lots of love and a good breakfast. This unprepared parent is the one at risk of potentially hurting a child when faced with an unusual amount of traumatic stress.

I once received a very disturbing phone call from an adoptive couple in their early 30s who adopted two children at the same time from Russia. One child was 15 months old and the other child was 5 years old. The mother called me because the older child was very hyperactive and aggressive, was wetting the bed regularly, and having all sorts of other behavioral problems.  She proceeded to mention that she now has to take care of the other child, with feeding and changing diapers, while simultaneously dealing with the older boy’s behavioral problems. These problems were causing undue stress on the entire family unit. She wanted to know if she could return this child back to Russia?

I could understand how toddler issues, such as diaper changes, and preschool-age issues, such as aggressiveness, could cause problems for a first-time mother. However, children are not objects that can be returned to the store. I later called their agency and inquired about the family’s preparation, and the agency responded by stating, “The parents waived their opportunity for parenting classes because they felt they knew everything about raising children.” Obviously, if they would have been better prepared, they would have realized that they could handle only one child at a time. Unfortunately, this child had to be taken out of the home and placed with another family in the U.S.

Adoption physicians and general pediatricians have a key role in helping the families with their newly adopted children. During the pre-adoption medical record review, a physician may provide some anticipatory guidance and tips on the immediate care of the child after the adoption is finalized. Parents need to be educated on how to transition their child from the orphanage to the adoptive family unit.

During the post-adoption medical examination, other than just looking for unknown medical conditions, we need to help counsel parents on how to deal with the emotional and psychological needs of the child before it turns into a medical condition.

All of my successful adoptive families were the people who were educated on the potential medical and behavioral issues that may occur. They expected the worst, hoped for the best, and worked with their child. When problems arose, these parents sought out professional support services in order to help them deal with the problems as they arise. By encouraging all adoptive parents to follow the same path, we may be able to make child abuse of the internationally adopted child a preventable condition.

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Sonia Billadeau


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